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MHLR summary

This page lists cases for which a case summary has been supplied by Kris Gledhill, Editor of the Mental Health Law Reports.

The pages below are initially ordered according to the dates on which they were added to the site (most recent first). The order can be changed by clicking on the symbol beside a column heading: click on the symbol beside "Page and summary" for alphabetical order; click beside "Categories" for the order in which the cases were reported. Click on the arrow symbol again to reverse the order. Click on a page name to view the relevant page.

WH v Partnerships in Care [2015] UKUT 695 (AAC), [2015] MHLO 132 — The tribunal, having decided that the appropriate treatment test in s72(1)(b)(iia) was met, refused to discharge a patient who had a diagnosis of dissocial personality disorder. (1) The Upper Tribunal allowed the appeal on the following grounds: (a) The appropriate treatment test relates only to the treatment that a patient is receiving at the detaining hospital, so the tribunal erred in law by considering the test met because treatment was available elsewhere. (b) The tribunal also erred in law by providing inadequate reasons: (i) the reasons were not set out by reference to the relevant criteria; (ii) the tribunal failed to address any of the solicitor's submissions about appropriate treatment; (iii) it was unclear what evidence was accepted or rejected, and why; (iv) the tribunal made findings which were wholly unsupported by the evidence. (2) The Upper Tribunal also stated that: (a) The tribunal is required to evaluate the evidence and reach its own conclusions, so was not obliged to accept the RC's opinion that no appropriate treatment was available; (b) Looking at the evidence as a whole, it was not necessarily the case that there was no evidence of appropriate treatment being provided to the patient; (c) It would be desirable for the MHRT for Wales to adopt the English Practice Direction on Reports, as the Welsh Rules provided little useful guidance, and full reports would have assisted in this difficult case; (d) The patient was currently detained in England so the Welsh tribunal was invited to transfer the case to England.

R (Dyer) v Welsh Ministers [2015] EWHC 3712 (Admin), [2015] MHLO 109 — "In this claim, the Claimant challenges an alleged failure by the public authorities responsible for the National Health Service in Wales to discharge the duty imposed upon them by section 3(1) of the National Health Service (Wales) Act 2006 to provide hospital accommodation 'throughout Wales, to such extent as they consider necessary to meet all reasonable requirements'. In particular, she contends that the duty has been breached because no decision has been taken by any authority as to either (i) the 'reasonable requirements' of women in Wales with ASD and LD for secure in-patient assessment and treatment; or (ii) the level of provision necessary to meet the reasonable requirements found to exist. Indeed, the relevant authorities have not only failed to make those decisions, it is said that they have failed to collate the information required to make them; and so they are not even in a position to make properly informed (and, therefore, lawful) decisions. That is the legal basis of the claim. However, the concern of the Claimant and her family underlying the claim is more personal and practical in nature. The last time the Claimant required compulsory detention on account of her mental condition was in August 2014 when, because there was no appropriate and available facility in Wales, she was sent to a hospital in Brighton where she was detained for some weeks. ... However, this court can intervene only if a decision-making authority has acted unlawfully. For the reasons I have given, none of the Defendants has done so in this case."

AM v Partnerships in Care Ltd [2015] UKUT 659 (AAC), [2015] MHLO 106 — The First-tier Tribunal, on the basis of their finding that the patient had committed two rapes, refused to discharge because sexual understanding and treatment work had not been undertaken. The Upper Tribunal held: (1) The tribunal had made a mistake of fact which undermined its conclusion as to the rapes, which was a fundamental error in the light of which the tribunal’s decision not to discharge could not stand. (2) The tribunal’s decision was made in error of law because of its failure to take into account relevant considerations. It had not scrutinised the evidence carefully or addressed features of the evidence which may cast doubt on the allegations; rather, the reasons gave the impression that, having found that AM lacked credibility generally, the tribunal simply and illogically accepted that the rape allegations were true because they were viewed as credible at the time. (3) A decision as to risk must involve findings of fact, not merely suspicion that an act was done which would be indicative of risk. Although the discharge criteria involve mixed questions of fact and judgement or evaluation, the judgement or evaluation of what is likely to occur must be based on fact. The next tribunal may consider that there are relevant facts other than the alleged rapes.

MM v WL Clinic [2015] UKUT 644 (AAC), [2015] MHLO 103 — (1) For the purposes of Article 5, a restricted patient with the capacity to do so can give a valid and effective consent to conditions of a conditional discharge that when implemented will, on an objective assessment, create a deprivation of liberty. (2) In determining whether to discharge conditionally, the tribunal has to consider whether the consent is freely given and (as raised in KC at [134-139]) consider any practical problems arising from the ability to withdraw consent. (3) MM's case was remitted to the First-tier Tribunal with a direction that it apply the decisions in KC and this case. (Caution: see Court of Appeal decision.)

R v Brown (formerly Latham) [2015] EWCA Crim 1328, [2015] MHLO 100 — "The central ground of appeal is that the appellant's conviction is unsafe because the ruling of the judge – viz. that the appellant's conferences at court with his lawyers were to take place in the presence of two nurses from Rampton Hospital – breached his right at common law to consult privately with his lawyers and under Article 6(3)(c) European Convention on Human Rights to "defend himself through legal assistance of his own choosing" (with the concomitant right to private discussions with his lawyers). ... In our judgment, by way of an additional common law qualification or exception to the inviolable nature of legal professional privilege, and in what is likely to be an extremely narrow band of cases, it will be appropriate to impose a requirement that particular individuals can be present at discussions between an individual and his lawyers if there is a real possibility that the meeting is to be misused for a purpose, or in a manner, that involves impropriety amounting to an abuse of the privilege that justifies interference. This case exemplifies the rare circumstances in which it will be necessary to take this step."

PJ v A Local Health Board [2015] UKUT 480 (AAC), [2015] MHLO 63 — The MHRT for Wales had rejected PJ's argument that his CTO should be discharged because its conditions unlawfully deprived him of his liberty. He appealed to the Upper Tribunal. (1) In deciding that PJ was not deprived of his liberty, the MHRT had erred in law in its application of the Cheshire West decision. (2) The MHRT also erred in law in concluding that the CTO framework must take precedence over any human rights issues. The tribunal must take into account whether the implementation of the conditions of a CTO will or may create a breach of Article 5 or any Convention right. If an issue remains to be decided on whether a breach exists or could be avoided (by authorisation or consent, or changing conditions), then generally the tribunal should adjourn to give an opportunity to make lawful the implementation of conditions. But if the treatment could not be provided without breach of Convention rights then the tribunal (whether by the statutory criteria or under its discretion) should discharge the CTO. (3) Guidance to tribunals was given under the following (paraphrased) headings: (a) whether implementation of the conditions will objectively amount to a deprivation of liberty; (b) whether the patient has capacity to consent; (c) if the patient has capacity, whether consent avoids a breach of Article 5; (d) if the patient lacks capacity, whether the objective deprivation of liberty can be authorised under the MCA; (e) if the patient lacks capacity, whether s64D can be relied upon to avoid an Article 5 breach; (f) how the conclusions on the above should help decide whether to adjourn, or discharge or uphold the CTO. (Caution: see Court of Appeal decision.)

R (Cornwall Council v SSH [2015] UKSC 46, [2015] MHLO 61 — "PH has severe physical and learning disabilities and is without speech. He lacks capacity to decide for himself where to live. Since the age of four he has received accommodation and support at public expense. Until his majority in December 2004, he was living with foster parents in South Gloucestershire. Since then he has lived in two care homes in the Somerset area. There is no dispute about his entitlement to that support, initially under the Children Act 1989, and since his majority under the National Assistance Act 1948. The issue is: which authority should be responsible? This depends, under sections 24(1) and (5) of the 1948 Act, on, where immediately before his placement in Somerset, he was "ordinarily resident". There are three possible contenders: Wiltshire, as the authority for the area where he was living with his family when he first went into care, and which remained responsible for him under the 1948 Act; Cornwall, where his family have lived since 1991; or South Gloucestershire, where he lived with his foster parents from the age of four until his move to Somerset. ... Although none of the other authorities has argued that Wiltshire should be responsible, the court indicated at the beginning of the hearing that this possibility should not be excluded from consideration. ... In a case where the person concerned was at the relevant time living in accommodation in which he had been placed by a local authority under the 1989 Act, it would be artificial to ignore the nature of such a placement in that parallel statutory context. He was living for the time being in a place determined, not by his own settled intention, but by the responsible local authority solely for the purpose of fulfilling its statutory duties. In other words, it would be wrong to interpret section 24 of the 1948 Act so as to regard PH as having been ordinarily resident in South Gloucestershire by reason of a form of residence whose legal characteristics are to be found in the provisions of the 1989 Act. Since one of the characteristics of that placement is that it did not affect his ordinary residence under the statutory scheme, it would create an unnecessary and avoidable mismatch to treat the placement as having had that effect when it came to the transition in his care arrangements on his 18th birthday. On this analysis it follows that PH's placement in South Gloucestershire by Wiltshire is not to be regarded as bringing about a change in his ordinary residence. Throughout the period until he reached 18 he remained continuously where he was placed by Wiltshire, under an arrangement made and paid for by them. For fiscal and administrative purposes his ordinary residence continued to be in their area, regardless of where they determined that he should live. It may seem harsh to Wiltshire to have to retain indefinite responsibility for a person who left the area many years ago. But against that there are advantages for the subject in continuity of planning and ..→

R v Vowles; R (Vowles) v SSJ [2015] EWCA Crim 45, [2015] EWCA Civ 56, [2015] MHLO 16 — "There are before the court: (1) Sitting as the Court of Appeal Criminal Division six cases where indeterminate sentences (either imprisonment for public protection (IPP) or a life sentence) had been passed between 1997 and 2008. Each specified a minimum term. In each case there was psychiatric evidence before the court with a view to a judge considering making a hospital order under MHA 1983 s37 as amended with a restriction under s41 of the same Act. The sentencing judge did not make such an order, but each was subsequently transferred to hospital under a transfer direction made by the Secretary of State under s47. (2) Sitting as the Court of Appeal Civil Division, a civil appeal in relation to a judicial review brought by the first of the appellants in the criminal appeals of the actions of the Secretary of State for Justice and the Parole Board relating to delay in the determination of her application for release from custody." In relation to the criminal aspect: in cases where medical evidence suggests mental disorder, the offending is partly or wholly attributable to that disorder, treatment is available and a hospital order may be appropriate, the court should consider (and, if appropriate, make) a s45A order before considering making a hospital order.

R v Wells [2015] EWCA Crim 2, [2015] MHLO 5 — "In each appeal and application before the court, the defendant has been found unfit to plead: that is to say, based on medical evidence, the court has found that one or more of the following criteria is satisfied namely that he or she does not have the ability to plead to the indictment, to understand the course of the proceedings, to instruct a lawyer, to challenge a juror, to understand the evidence. ... Where a defendant's disability impacts on his/her ability to take part in a trial but he/she is not otherwise affected by a psychiatric condition such as renders what is said in interview unreliable (whether or not the delusional traits are apparent on the face of the interview), there is no reason why the jury should not hear them albeit with an appropriate warning. When considering the extent to which evidence of the interview should be admitted, it remains relevant to consider all the circumstances."

R (Lee-Hirons) v SSJ [2013] EWHC 1784 (Admin), [2013] MHLO 54 — "For the detailed reasons set out above I am satisfied that the decision to recall the Claimant was lawful because there had been a deterioration in his mental health since the hearing before the Tribunal. I find that there is a duty to give the patient who is being recalled oral reasons for that decision. I am satisfied that the Claimant was told of the reasons for his recall. I therefore dismiss the claim for damages for false imprisonment and breaches of article 5 of the ECHR, and I dismiss the claim for a declaration." [Summary required.]

GA v Betsi Cadwaladr University Local Health Board [2013] UKUT 280 (AAC), [2013] MHLO 50 — (1) Although the patient argued that he was not giving true consent to depot medication on a CTO, the tribunal decided that he was in fact consenting (this finding was not addressed on appeal). (2) If the tribunal have found that the statutory criteria are met (in CTO cases, effectively that the patient requires treatment and should be subject to recall), then, before granting a discretionary discharge, the tribunal must be satisfied that the identified needs for treatment and protection can be properly catered for, as otherwise the decision would be self-contradictory and perverse. [A more detailed summary is available on the case page.]

R (Afework) v LB Camden [2013] EWHC 1637 (Admin), [2013] MHLO 51 — The judge held that as a matter of law s117(2) is only engaged vis-à-vis accommodation if: '(i) The need for accommodation is a direct result of the reason that the ex-patient was detained in the first place ("the original condition"); (ii) The requirement is for enhanced specialised accommodation to meet needs directly arising from the original condition; and (iii) The ex-patient is being placed in the accommodation on an involuntary (in the sense of being incapacitated) basis arising as a result of the original condition.' No obvious reason is given for the third requirement, which is probably wrongly decided (or, as the COP Newsletter puts it, 'will fall to be considered again in due course').

EC v Birmingham and Solihull Mental Health NHS Trust [2013] EWCA Civ 701, [2013] MHLO 47 — The appellant restricted patients had sought extra-statutory recommendations, in relation to leave and transfer, but the First-tier Tribunal had refused, without hearing evidence, to make recommendations. (1) The parliamentary answer in relation to extra-statutory recommendations given by a Home Office minister on 28/10/87, and the fact that recommendations had been made and considered in the past, did not give rise to a legitimate expectation that the tribunal would entertain submissions that a recommendation should be made. (2) If the FTT had been faced with the contention that leave or transfer were necessary or available parts of the patient's treatment (in relation to the test in s72(1)(b)(iia)) it would have had to consider it, but in these cases it had not been. [Summary based on Lawtel and All ER (D) reports.]

R v Dixon [2013] EWCA Crim 465, [2013] MHLO 42 — (1) Despite the appellant's intellect and condition the judge was entitled to permit the jury to draw an adverse inference from his failure to give evidence. (2) The appellant argued that fresh medical evidence showed the judge's decision was wrong, but this evidence was not admitted. (3) The appellant had been able meaningfully to participate in his trial, which was fair, and the conviction was safe. (4) The minimum term of the appellant's detention at Her Majesty's pleasure was reduced from 14 to 13 years.

R (Z) v Whittington Hospital [2013] EWHC 358 (Admin), [2013] MHLO 29 — "The claimant, Mrs Z, who very ably represented herself, was sectioned under the Mental Health Act shortly after giving birth to her first baby after a prolonged and very difficult labour. ... Miss Z says that looking at the reasons that were given at the time, which are recorded in a document signed by both doctors (Form A3, that is the formal sectioning document) the reasons that are there recorded are insufficient reasons to warrant her detention under the Mental Health Act." [Summary required.]

R v Caress [2013] EWCA Crim 218, [2013] MHLO 27 — "In the circumstances, there is no reason to believe that the diagnosis at the time of sentence was wrong or that sentence [a restricted hospital order] was passed on a wrong factual basis. If, as appears to be the case, the diagnosis has now changed that is a matter that should be dealt with by the Mental Health Tribunal, rather than by late appeal against sentence." [Summary required.]

Mihailovs v Latvia 35939/10 [2013] ECHR 65, [2013] MHLO 15 — "The applicant alleged, among other things, that he had been held against his will in a State social care institution for more than ten years, that he could not obtain release, and that he had been fully dependent on his wife, who had been his guardian, had not represented his interests, and had opposed all attempts by him to defend his rights."

R v Aspinall (Paul James) [1999] MHLR 12 — The failure to follow the requirements to have an appropriate adult in the interview of a mentally disordered suspect meant that, despite his apparent lucidity in interview, it was unfair to admit it in evidence. [MHLR.]

Re D (mental patient: nearest relative) [1999] MHLR 181 — The approach to whether a relative “cares for” a patient so as to become their nearest relative by reason of s26(4) Mental Health Act 1983 involves the provision of more than minimal care services; the social worker’s decision as to who “appears to be” the nearest relative for the purposes of consultation under s11(4) of the Act has to involve an acceptable approach to the question of who is the nearest relative but did not require the making of enquiries (unless it would be irrational not to make enquiries). [MHLR.]

R (Moyle) v London South and South West Region MHRT [1999] MHLR 195 — A Tribunal is not acting in an appellate or review jurisdiction, but exercising an original jurisdiction in which it forms an evaluative judgment as to whether the criteria for discharge are made out; as such, it may disagree with the evidence in front of it. When the illness is one that will relapse in the absence of medication, the appropriateness of liability to detention depends on an assessment of the probability of relapse in the near future. (At the time, the test for discharge placed the burden of proof on the patient and so the patient had to show that there was no probability of relapse to demonstrate that the nature of the illness did not justify detention; it was also held that the admission criteria had to be considered, but in the context of the burden of proof being reversed. Its conclusion that the admission criteria were not relevant meant that there was an error of law that led to the decision being quashed.) [MHLR.]

R (Hagan) v Anglia and Oxfordshire MHRT [1999] MHLR 204 — In relation to the powers as to classification and reclassification of categories of mental disorder that existed under the MHA 1983 before its amendment by the MHA 2007, the question to be asked as to the use of the power was whether the patient had a mental disorder in a particular category (even if it was in remission) not whether that mental disorder was such as to justify detention. Accordingly, a Tribunal was not required to reclassify a patient who had been detained on the basis of 2 forms of disorder as being detained only under 1 form when the other was in remission and would not justify detention. [MHLR.]

Ferguson v State Hospital Management Committee [1999] ScotSC 10 — In considering discharge, it was not necessary to consider the hypothetical question of whether the sentencing court would impose a hospital order on the basis of present knowledge of the patient’s condition; the requirement of treatability in relation to a personality disorder was satisfied by the structured setting that made F more settled and stable and cognitive behavioural therapy and counselling. [MHLR.]

Ruddle v Secretary of State for Scotland [1999] ScotSC 24 — Whilst a structured hospital environment could amount to treatment, it did not on the facts, but was mere containment; and as an anti-social personality disorder was not on the facts alleviated or prevented from deterioration as a result of any treatment interventions, it was untreatable; and as there was no need for recall, an absolute discharge followed. [MHLR.]

Wilkinson v Secretary of State for Scotland (1999) ScotCS 49 — Paedophilia alone did not justify detention, as it is a sexual deviancy; but on the facts there was a mental disorder. If there is a mental disorder that manifests itself in paedophile conduct, that can be within the definition of mental disorder. [MHLR.]

R v Cox (Lee Michael) [1999] EWCA Crim 848 — The judge was able to impose a restriction order against the views of the doctors giving evidence; there was assistance as to the meaning of “serious harm” in the s31 Criminal Justice Act 1991, and so it covered serious physical or psychological injury; the risk of such harm had to be real, not fanciful or remote. [MHLR.]

R v Crookes [1999] EWCA Crim 1065 — On an appeal against a restriction order, the progress made after sentence can be relevant to show that a restriction order, although properly imposed, should be lifted by the Court of Appeal. [MHLR.]

Broadmoor Hospital Authority v R [1999] EWCA Civ 3039 — A High Secure hospital has a duty to treat patients, maintain security and provide a therapeutic environment; and implicit rights and powers to secure these objectives, including seeking to control events outside the hospital that might impact upon its duties. [MHLR.] (No injunction to prevent patient publishing book about index offence.)

Re GK (Patient: Habeas Corpus); Kinsey v North Mersey Community NHS Trust [1999] EWHC Admin 577 — The statutory provisions meant that a hand delivered notice of intention to discharge by a nearest relative had to come into the hands of the Mental Health Act Administrator to start the 72 hour period for a barring order (s25 Mental Health Act 1983); if the notice was sent by post to the Managers, it was their responsibility to ensure that an authorised officer was available to open it and deal with it. [MHLR.]

Merrill v Herefordshire District Council [1999] EWCA Civ 1976 — It had been within the judge’s discretion not to adjourn displacement proceedings involving a nearest relative alleged to be mentally incapable of acting as nearest relative who sought an adjournment in order to obtain legal representation; and the displacement order was open to the judge on the evidence. It was suggested that the displaced nearest relative had no right to apply to the Mental Health Review Tribunal. [MHLR.]

R (AX London) v Central London County Court [1999] EWCA Civ 988 — The county court can, on an ex parte application, make an interim displacement order under s29; it is lawful to detain a patient under s3 on the basis of it, although unless there are cogent reasons it is preferable to wait until the final order; even if the order had been declared invalid, the decision to admit the patient would still be valid.

R (Gilkes) v SSHD [1999] EWHC Admin 47 — One of the two medical reports was too out-of-date to be reasonably relied upon for a s47 transfer to hospital; a transfer at the end of a prison sentence was not inherently unlawful; based on subsequent material from the same doctor, no relief would be granted as if the Secretary of State had insisted on an up-to-date report he would have made a transfer direction anyway.

Matter v Slovakia 31534/96 [1999] ECHR 38 — Proceedings relating to capacity are covered by Art 6 ECHR; in assessing whether the proceedings are completed within a reasonable time, account has to be taken of any complexity arising from the need for expert evidence and any conduct by the patient, but special diligence is required from the court in light of the importance of the question. A forced medical examination, which is an interference for the purposes of Art 8(1), could be a proportionate method of protecting a patient’s rights as part of the resolution of capacity proceedings and so justified for the purposes of Art 8(2) ECHR. [MHLR.]

Musial v Poland 24557/94 [1999] ECHR 15 — Requesting a second opinion did not amount to a waiver of the right to a speedy hearing; the court’s agreement to request a second opinion did not absolve it of the duty to ensure speediness (including using powers such as the fining of witnesses); complexity of a medical file was relevant to the issue of speediness; reliance on an out-of-date medical report could breach Art 5. [MHLR.]

Cotterham v UK [1999] ECHR 185 — The 10-month delay between the MHRT application and the hearing at first sight appeared to be a breach of Article 5(4); however, in the circumstances, there was no lack of diligence on the part of the judicial authorities: the delays were due to postponements for an independent report which arrived late and was served later still, and for the solicitor to be available.

Croke v Ireland 33267/96 [2000] ECHR 680 — The applicant's case under Article 5 (about the absence of an independent and automatic review prior to or immediately after his initial detention in a psychiatric institution and about the absence of a periodic, independent and automatic review of his detention thereafter) was struck out of the list on the basis of a friendly settlement based on the Southern Irish government's intention to enact the Mental Health Bill 1999 to replace the Mental Treatment Act 1945.

FC v UK (1999) 37344/97 [1999] ECHR 184 — The applicant complained under Article 8 of the Convention that her adoptive father (whom she claims sexually abused her) automatically became her nearest relative under s26, that he consequently had access to personal information about her (including her treatment and whereabouts) and that she was not entitled to apply to have someone else act as her nearest relative; the case was struck out of the list by way of a friendly settlement on the basis that the government would change the law.

R (Hall) v MHRT [1999] EWCA Civ 2052 — The fact that there will be delay in the implementation of conditions in a conditional discharge does not mean that they are unlawful; it would have been open to the Tribunal to be proactive in adjourning for reports as to the progress of an aftercare package. [MHLR.]

R (Hall) v MHRT [1999] EWHC Admin 351 — The provisions of s117 Mental Health Act 1983 are designed to ensure that there is always an aftercare authority, being the place where the patient resided before detention or, if there was no such residence, the place where the patient was to be sent on release; the duty as to aftercare included the provision of information to a Tribunal and so arose before discharge. [MHLR.]

R (Manns) v London North and East MHRT [1999] EWHC 497 (Admin) — A Tribunal had been entitled to find that there was an enduring mental illness based on symptoms before transfer to hospital and that it was asymptomatic because of a response to medication; this entitled it to reject an opinion in favour of discharge which was based on the view that there was no enduring illness. [MHLR.]

R (Wey) v Pathfinder NHS Trust [1999] EWHC Admin 672 — When the Tribunal has decided on classification, the RMO cannot subsequently reclassify unless there is some change in circumstance of a significant kind which would enable a tribunal to take a different view if the matter were referred to them again. The remedy to the doctor and to the Trust would instead be to apply for judicial review of the decision of the Tribunal